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NURS 5334 ADVANCED PHARMACOLOGY MODULE 2 EXAM QUESTIONS AND ANSWERS LATEST UPDATED 2025

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physiologic changes during pregnancy & drug impact - ANSWER- 3rd trimester = renal blood doubles, renal excretion accelerated - tone and mobility of bowel decreases - prolongation of drug effects placental drug transfer - ANSWERall drugs can cross the placenta, some cross more easily than others adverse reactions during pregnancy - ANSWERcan adversely affect both pregnant pt and fetus - heparin - osteoporosis - prostaglandins - stimulate uterine contraction - some pain relievers can be used during delivery can cause respiratory depression in baby teratogenesis birth defects - ANSWERgross malformations = cleft palate, clubfoot, hydrocephalus neurobehavioral & metabolic anomalies 3 stages of teratogenesis development - ANSWER1. conception through week 2 2. embryonic period week 3-8 = gross malformations 3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure embryonic stages - ANSWER identification of teratogens - ANSWERdifficult to identify, 3 criteria must be met: 1. The agent must be present during the critical stage of development 2. The agent produces a particular pattern of birth defects in animal studies. 3. The agent crosses the placenta and there is a dose-response relationship. responding to teratogen exposure - ANSWERDetermine when the drug was taken Determine when the pregnancy began -Weeks 3-8 (organogenesis) is most crucial time Determine type of malformation expected Conduct 2 US and consult FDA to determine severity

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NURS 5334 ADVANCED
PHARMACOLOGY MODULE 2 EXAM
QUESTIONS AND ANSWERS LATEST
UPDATED 2025

,physiologic changes during pregnancy & drug impact - ANSWER- 3rd trimester = renal
blood doubles, renal excretion accelerated
- tone and mobility of bowel decreases -> prolongation of drug effects

placental drug transfer - ANSWERall drugs can cross the placenta, some cross more
easily than others

adverse reactions during pregnancy - ANSWERcan adversely affect both pregnant pt
and fetus
- heparin -> osteoporosis
- prostaglandins -> stimulate uterine contraction
- some pain relievers can be used during delivery can cause respiratory depression in
baby

teratogenesis birth defects - ANSWERgross malformations = cleft palate, clubfoot,
hydrocephalus

neurobehavioral & metabolic anomalies

3 stages of teratogenesis development - ANSWER1. conception through week 2
2. embryonic period week 3-8 = gross malformations
3. fetal period week 9-delivery = functions disrupted w/ teratogen exposure

embryonic stages - ANSWER

identification of teratogens - ANSWERdifficult to identify, 3 criteria must be met:

1. The agent must be present during the critical stage of development
2. The agent produces a particular pattern of birth defects in animal studies.
3. The agent crosses the placenta and there is a dose-response relationship.

responding to teratogen exposure - ANSWERDetermine when the drug was taken

Determine when the pregnancy began
-Weeks 3-8 (organogenesis) is most crucial time

Determine type of malformation expected

Conduct 2 US and consult FDA to determine severity

how to decrease risk of drug effects during breastfeeding - ANSWER- take drugs
immediately after breastfeeding

, - avoid drugs w/ long half-lives
- choose drugs that tend to be excluded from milk, least likely to affect infant
- avoid hazardous drugs

pediatric response to drugs - ANSWER- more sensitive to drugs
- greater individual variation
- sensitivity d/t organ system immaturity
- increased risk for adverse rxns

determining the intensity of duration of drug response in neonates & infants - ANSWER-
elevated drug levels = more intense response
- delayed elimination = prolonged response
- immaturity of organs = risk for both^

comparison of plasma drug levels in adults and infants - ANSWER

increased sensitivity in infants caused by immature state of... - ANSWERabsorption,
protein binding of drugs, BBB, hepatic metabolism, renal drug excretion

infant absorption: oral administration - ANSWERprolonged and irregular gastric
adult function at 6-8 months

infant absorption: gastric acidity - ANSWER- very low 24 hours after birth
- does not reach adult values for 2 years
- low acidity = absorption of acid-labile drugs is increased

infant absorption: intramuscular admin - ANSWERslow, erratic, delayed absorption as
results of low blood flow in 1st few days of life

in early infancy, absorption of IM drugs more rapid than neonates & adults

infant absorption: transdermal - ANSWERmore rapid & complete for infants than older
children & adults
- stratum corneum of infant's skin is thin
- blood flow to skin is greater in infants than older patients
- infants increased risk for toxicity from topical drugs

infant distribution: BBB - ANSWER- not fully developed at birth
- drugs have easy access to CNS
- infants especially sensitive to drugs that affect CNS function
- dosage should be reduced for drug actions outside the CNS if those drugs are capable
of producing toxicity as a side effect

infant hepatic metabolism - ANSWER- drug-metabolizing capability of newborns is low
- liver's capability to metabolize drugs increases fast @ 1mo
- complete liver maturation occurs at 1yr

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